REPORT: Removing abortion pill's in-person requirement increases adverse event rate

An analysis by the Ethics and Public Policy Center (EPPC) suggests that the rate of serious adverse events following the use of the abortion pill (mifepristone) significantly increases when the in-person dispensing requirement is removed.

Key Takeaways:

• The EPPC analysis states that removing the in-person dispensing requirement for the abortion pill puts women at increased risk of serious adverse events.

• The analysis suggests that risks are significantly increased for women who are experiencing undiagnosed ectopic pregnancy.

The Details:

In April 2025, the EPPC released data showing that the rate of experiencing a serious adverse event when taking mifepristone is 22x higher than the Food and Drug Administration (FDA) claimed.

Now, the EPPC has released data showing that when mifepristone (the first drug of the two drug abortion pill regimen) is taken without a doctor's oversight, the risk of complications increases — including ectopic pregnancy.

The EPPC reviewed prescriptions for mifepristone from January 1, 2017 through December 31, 2023. It explained:

The in-person dispensing requirement was in effect through more than the first half of that period, until a federal judge enjoined it on July 13, 2020. It was also briefly in effect from January 12, 2021 (when the Supreme Court stayed the federal judge’s injunction) until April 12, 2021 (when the FDA announced that it was suspending the requirement during the Covid-19 pandemic). In December 2021, the FDA announced that it would revise the REMS to eliminate the in-person dispensing requirement, and the change was finalized in January 2023.

The EPPC's analysis of the data revealed:

• The rate of serious adverse events when the abortion pill was dispensed in person was 10.15%.

• This rate increased to 11.50% when the in-person dispensing requirement was lifted.

• This is a 1.35 percentage point increase, which is considered statistically significant.

• It's also far higher than the 0.5% rate of serious adverse events listed on the FDA's mifepristone drug label.

Ectopic pregnancy rate:

• The rate at which women were prescribed mifepristone despite having an ectopic pregnancy rose from 0.27% to 0.41%.

• Mifepristone does not treat an ectopic pregnancy and therefore, it continues undetected after the woman takes mifepristone, leading to fallopian tube rupture and risk of infection and death.

• In-person requirements help protect women by allowing a doctor to examine them and potentially detect the ectopic pregnancy so it can be treated appropriately. (Treatment for ectopic pregnancy is not an abortion.)

READ: BAD ACTORS: Abortion pill clients left to deal with ectopic pregnancies on their own

The abortion pill now accounts for at least 63% of all abortions in the United States, and since 2020, the virtual abortion market share rose from 0% to 19% in the fourth quarter of 2023, according to data cited by the EPPC.

The EPPC estimated that if "remote dispensing of mifepristone accounted for 10% of all prescriptions in Period 2" it could be assumed that over three years, the market share could rise to 30%, implying a rate of 23.65% of serious adverse events related to virtual abortion pill dispensing. It explained (emphasis added):

A serious adverse event would be 2.33 times as likely under remote dispensing as under in-person dispensing, and more than 47 times the “less than 0.5 percent” rate of serious adverse events reported on the drug label. Under this 10% scenario, the provision of mifepristone to a woman with an ectopic pregnancy would be more than six times as likely with remote dispensing as with in-person dispensing.

Why It Matters:

Despite marketing for the abortion pill claiming mifepristone is safe to take even without a doctor's supervision, real world data is proving otherwise.

Although abortion businesses can bring in a lot of money selling abortions with little to no overhead costs or doctors office hours, women are arriving at emergency rooms with serious complications associated with the abortion pill. (A pro-abortion ER doctor recently noted this on social media.)

1st Trimester Abortion | The Abortion Pill | What Is Abortion?

With no medical exam prior to taking mifepristone (some women are acquiring the drug before they are even pregnant, against FDA protocols), and no doctor to follow-up to ensure the abortion pill has worked, women are being put in grave danger.

The abortion pill's risks include hemorrhaging and incomplete abortion which leads to infection and sepsis. There are also the risks associated with undiagnosed ectopic pregnancy which can cause fallopian tube rupture and death.

The Bottom Line:

The truth of the dangers of mifepristone are being exposed and women deserve to understand the risks and receive care that doesn't prioritize industry profits.